| NPI | 1023667524 |
|---|---|
| Doing Business As | GEM STATE DEVELOPMENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | LORI JO POOLE Clinical Director 208-888-5566 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2019-09-06 |